Recognition

Suspicion of an underlying infectious, inflammatory or neoplastic disorder triggers a physician to order a serum protein electrophoresis. This is a simple screening technique commonly used in clinical medicine that displays serum proteins by their electric charge (Figure 1). Media include cellulose acetate and agarose. Separate bands are seen for albumin, alpha-1 globulin, alpha-2 globulin, beta and gamma globulin. Polyclonal or monoclonal increases may be detected when the electrophoretic bands are scanned. Capillary electrophoresis gives better resolution of separate bands. When the increase is polyclonal it appears as a broad band and the electrophoretic tracing shows a broad-based increase reflecting heterogeneous immunoglobulins being produced by polyclonal plasma cells. This increase is usually in the gamma region but may extend to the beta region. When the increase is monoclonal, the electrophoretic band is narrow and the electrophoretic tracing shows a narrow-based band reflecting the homogeneous electric charge of the monoclonal immunoglobulin.

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